Other People's Words

Interview w/ Dr. Simon Baron-Cohen

Posted in Uncategorized by Tera on November 24, 2010

This is a transcript of Autism Women’s Network’s interview with Professor Simon Baron-Cohen.

[Music]

Sharon daVanport: Hello, everyone, and welcome to AWN radio. We are the Autism Women’s Network on Blogtalk. We’re streaming to you live over the Internet from the beautiful Midwest, USA. I am your host, Sharon daVanport, and today is Monday, November 15, 2010. In just a few minutes we will be bringing on our guest for the hour, Professor Baron-Cohen.

First, we have one quick announcement. To enter AWN radio’s monthly prize giveaway that we’ve been doing for several months now—our sponsor, LifePROTEKT, you only need to submit your story to us here at Autism Women’s Network, as to why your loved one would benefit from a GPS location device. Our e-mail address fo that entry is info AT autismwomensnetwork DOT org. We wanna thank everyone for their entries, and just know that once you submit your entry, it is good for a year. Good luck.

Now, without further ado, we want to bring on Professor Simon Baron-Cohen, and we’re very pleased that he’s joining us today. We’re especially pleased Professor Baron-Cohen is a part of our advisory board for AWN, and we were happy that when we first contacted the professor, he asked a lot about the network, looked into it. Our advisory board is set up in a way that we wanna have a very diverse membership. If a lot of people go over to our website, they will see that a lot of our advisory board members have different community involvement for autism, and bring a lot to our community in very many different ways. We wanted that diversity so we could draw upon them when we need their advice. So we thank Professor Baron-Cohen for that. So, professor, I’m so glad that you could join us.

Professor Simon Baron-Cohen: Hi, Sharon. It’s a pleasure to be on your show.

Sharon daVanport: Thank you; thank you. First we wanted to start off with what you are currently doing. We’re going to also get to a lot of what you’ve done in the past, and what you’ve authored. I especially appreciate the DVD by Jessica Kingsley that you’ve done. I think maybe I’d like to start there. If you could let us know a little bit about that, about Mind Reading.

Professor Simon Baron-Cohen: Okay, sure. Well, our research looks basically at the causes of autism, [the] autism spectrum, but also at interventions: what might be helpful. And the DVD is an example of some of our research, to see whether we could teach emotion recognition to people on the autistic spectrum. Emotion recognition is sometimes an area of challenge for people with autism or Asperger’s Syndrome, particularly reading emotions from faces and reading emotions from people’s voices.

So the DVD is called Mind Reading, and it’s effectively like an encyclopedia of emotions. That sounds a bit dry, but on the DVD, what we’ve put in there are actors and actresses showing facial expressions of every human emotion, but also vocal intonation of every human emotion. And it was a fun project to work on, because the first point, the starting point, was: How many emotions are there? We identified at least 412 different emotions. Then we had to get the actors and actresses to perform each of these, and when you put the DVD into your computer, you can select what emotion you want to learn about. You can see what that emotion looks like on a male face or a female face, an old face or a young face, somebody of different ethnicities, and effectively just get an opportunity to practice or learn to recognize emotions.

Sharon daVanport: I just thought of something I think is quite interesting. You said the facial recognition tool helps those of us on the spectrum to see what a male as compared to a female face would look like when you’re observing different emotions. And of course, that’s going to lay later into your work about that aspect of it.

Professor Simon Baron-Cohen: Sure.

Sharon daVanport: But can you explain? I think that is so interesting, because that is one reason why the Autism Women’s Network has been so important to so many people: we are trying to show that there is a difference in female autism.

Professor Simon Baron-Cohen: Right.

Sharon daVanport: And females are different anyways, so. [Chuckles]

Professor Simon Baron-Cohen: Sure. You’re touching on a second area which is very interesting, about whether autism may be different in men and women, boys and girls. When we did our initial research for the DVD, we weren’t really looking at sex differences, or what in the US you call gender differences. We were simply focused on people with autism versus people without autism, so group differences of that kind.

But you’re absolutely right. In recent years, and one of the reasons why it’s been so important to set up the AWN is because more females are being diagnosed with autism, and research really has to investigate whether autism manifests itself differently in females compared to males.

Sharon daVanport: And the research that you have done yourself, can you give us your professional opinion and share with our listeners what you’re finding out so far as to why that is—the differences and why? We know that females like myself typically are diagnosed later in life.

Professor Simon Baron-Cohen: Yeah.

Sharon daVanport: We tend to mask better. Can you explain that for our listeners?

Professor Simon Baron-Cohen: Right. Well, I think at the moment, what we know about females with autism is very little. So what that means is that people like me in the research community need to be addressing females much more than we have in the past. So in the past, for many different reasons, most research either just focused on males or they combined males and females, but didn’t really look at them separately. I think what’s happened in recent years is that more and more women or teenage girls have come forward to seek a diagnosis and this is something new, because in the past we thought that the sex ratio in autism was about four males for every one female, and we just don’t know. That may be changing as more females come forward seeking a diagnosis.

You mentioned some interesting speculations, which is that girls may be better at masking their autism so they may end up receiving their diagnosis later, if at all. If a female with autism is really good at masking their autism, they may compensate to such a degree that they don’t need a diagnosis.

Sharon daVanport: Okay.

Professor Simon Baron-Cohen: But others find that they’re struggling in adolescence or in young adulthood, and that’s a time when they might seek a diagnosis. We know that for boys, they tend to get their diagnosis much earlier, in childhood.

Sharon daVanport: Okay. And with the tool also that is represented on the DVD, you speak of ethnicity and the differences in different ethnic facial expressions. Can you speak to that?

Professor Simon Baron-Cohen: Yeah, sure. Well, the reason for having a diversity of faces on the DVD is because when you’re wanting to learn to recognize a particular emotion, everyone shows emotions slightly differently. You can’t really with any precision say that everyone is going to show the same emotion in the same way. So what we did just as an effort toward recognizing that diversity is have six actors and actresses portray each emotion, and we included both sexes and a range of ethnicities, just to get some diversity. You could extend that.

You could’ve had 100 different actors showing the very same emotion, and you’d have seen that it’s slightly different on each person. But obviously we had to keep it within practical constraints, so we just limited it to six actors. But even that allows the opportunity to try to learn to recognize an emotion on one person, and then to generalize it across five more people.

Sharon daVanport: Okay; all right. Now I would like for this to be a segue into the work you’ve done. You authored Mindblindness and The Essential Difference: Men, Women and the Extreme Male Brain. For me, that was the first book I read of yours. It was recommended to me when I was first diagnosed. Can you speak to our listeners about that and the work that was behind that?

Professor Simon Baron-Cohen: Sure, yeah. You’ve mentioned two different books there. One was Mindblindness, which was published back in the mid-’90s, and that was really just describing the difficulties that people with autism have in picking up on other people’s thoughts and feelings. But the second book you mentioned was The Essential Difference.

Sharon daVanport: And that was the one that I read first. I’m sorry. That was the one I read first. That was the one that was really…even the title just caught my attention when it was e-mailed to me to look into that.

Professor Simon Baron-Cohen: Yeah, okay. So that book was published in 2003, and what I was trying to do there was link autism to what we know about typical sex differences, both psychologically and ultimately in the brain. The way I did it was to first of all look at which of the areas that either boys are developing faster or girls are developing faster in terms of behavior and skill. The two areas that I focused on, first of all, in terms of girls, was empathy. That girls are developing empathy faster than boys in the general population, by which I mean the ability to put yourself into someone else’s shoes and imagine what they might think or feel.

In contrast, boys are developing stronger interests in systems of one kind or another—what I called “systemizing.” It might be figuring out how gadgets work when it comes to a new computer game. Or it might be some other kind of system, like mathematics. These differences are differences on average. They don’t apply to all boys and all girls. It’s simply when you compare males and females on average, you see small but significant differences emerging. And the way I related that to autism was to ask the question: Might autism be an extreme of they typical male profile, where you have an individual who is finding it difficult to empathize, but at the same time, they’re getting very focused on systems—what some people called “obsessional,” and a very narrow focus on a specific system.

So we’ve been exploring that both in terms of psychology but also ultimately, and in recent years, using brain scanning and other biological investigations to look at whether people with autism might be an extreme of the typical male pattern of development.

Sharon daVanport: Okay. What are some of the current research projects that you have going on that tie in to this topic?

Professor Simon Baron-Cohen: Right. Well, one of them looks at hormones measured in the womb, and we’re particularly interested in the hormone testosterone. It’s a sex hormone, and this hormone is of interest because it’s involved in brain development. So we know from animal research that testosterone levels influence the masculinization of the brain, and we’re looking at this in humans by measuring testosterone in the womb. The way we do this is to ask women who are pregnant and who are having an amniocentesis, where a needle is introduced into the womb to look at the amniotic fluid. We’re asking those women if we can measure the testosterone in that fluid. That testosterone comes from the baby.

Then later we wait till the baby’s born. This is all done during pregnancy. We wait till the baby’s born and we follow them up to see whether there’s any relationship between the hormone levels prenatally and how that child behaves post-natally.

Sharon daVanport: Okay.

Professor Simon Baron-Cohen: And what we’ve been finding is that the higher the baby’s level of testosterone prenatally, the less eye-contact the baby makes post-natally, and the slower they are to develop socially, and also the slower they are to develop language.

Sharon daVanport: Okay. Now, if in fact your research pans out to show that this is indeed an effect that contributes to autism, when you tie that in to a lot of people, there have been some researches that it could be genetic. So how does that tie in to it not just being something that happened in the womb as opposed to something that’s genetic and a neurological genetic component?

Professor Simon Baron-Cohen: Sure. That’s a really good question, and the way I see it tying in is that, first of all, the hormone levels that the baby’s producing are themselves under genetic control. We know that some genes influence how much of this hormone you make. You also asked how does it tie in to neurological development. Again, I mentioned earlier that both genes but also hormones can affect neurological development. So this is not a theory about hormones acting alone; this is a theory about hormones affecting brain development and being regulated by genes. So it’s quite a complex mix of biological factors. And of course, we shouldn’t forget or ignore the importance of postnatal experience, because ultimately all of us are the result of a mix between our biology and our experience.

Sharon daVanport: Oh, absolutely. And I think, hands-down, most people absolutely can see that and identify with that in their own lives. When it comes to the work that you’re doing and the research, what are some of the results telling you? Have you been able to obtain any initial results?

Professor Simon Baron-Cohen: So I think you’re asking about the hormone studies still—

Sharon daVanport: Yeah, umhm.

Professor Simon Baron-Cohen: —but in relation to autism. We have a large study underway in collaboration with Denmark, because in Denmark they have a very large bio-bank where they’ve been collecting amniotic fluid since the 1980s. And so they have tens of thousands of samples in the deep-freeze, and they also have a register—it’s called the Danish Psychiatric Register—which can tell you who has gone on in the population to develop autism.

So what we’re doing in collaboration with these Danish scientists is to look to see if there’s any link between the testosterone level in thousands of amniotic samples and the likelihood of having a diagnosis of autism. And that work is in progress. Up to now we’ve just been looking at typically-developing children, and that’s simply because many women who have an amnio, this medical procedure, just go on to have a typically-developing child. So so far, all we’ve been able to investigate are individual differences in the general population. But it is obviously important to see whether this is also relevant to autism. That’s for the future.

Sharon daVanport: Oh, very interesting. When it comes to processing all of this data, what do you do in your work in collaboration with Denmark? What are you doing? Is it a closed study? Is it open? Can our listeners who are listening contact someone to be a part of that study? How does that work?

Professor Simon Baron-Cohen: Right. Well, that particular study, obviously, the only people who take part are women who had amniocentesis.

Sharon daVanport: Oh, okay.

Professor Simon Baron-Cohen: So that’s a very small subset of women in the population. It’s only about six percent of pregnant women who choose to have an amniocentesis.

Sharon daVanport: Oh, okay.

Professor Simon Baron-Cohen: But we do have a range of other studies where we encourage people to take part, and people sometimes participate in research online. They go to our website, which is The Autism Research Centre People can take questionnaires which help us measure behavior. And then locally, that’s to say in the UK, where I’m based, people come to visit the lab if they’re wanting to take part in face-to-face testing, including brain scans.

Sharon daVanport: Okay. And you speak about the online research.

Professor Simon Baron-Cohen: Yeah, yeah.

Sharon daVanport: Can you speak to some of the questions and some of the data that you’re attempting to retrieve?

Professor Simon Baron-Cohen: Sure. Just to give you some examples, we developed a questionnaire called the Autism Spectrum Quotient, and it’s shortened to the AQ. This is a way of measuring the number of autistic traits a person has. It really fits with this whole new way of thinking about autism,which is as a spectrum. But instead of just looking at people who turn up to clinics, it’s looking at the whole population. And what we’ve been finding is that the number of autistic traits in the population is normally distributed—that’s to say, we’re all somewhere on that spectrum. People who end up with a diagnosis simply score much higher, but actually when you invite people randomly selected in the population to fill out the questionnaire, very few people score zero. Everybody scores something on that measure.

Sharon daVanport: Okay.

Professor Simon Baron-Cohen: Just to give you an example, a typical female scores about 15 out of 50, and a typical male scores 17 out of 50. What we find is that people on the autistic spectrum, people with a diagnosis, score around 30 out of 50—so much higher. But it’s giving us a clue that autistic traits really are on a continuum. Then we can look to see what that measure correlates with. We can see if it correlates with aspects of brain structure, for example.

Sharon daVanport: I find this interesting, that you brought up that particular research, because it’s quite popular over on the networking site Facebook. You see it posted every day. If you go over there, you see it posted every day. I’ve taken it; I took it last year and I took it this year. I’ve actually taken it more than once.

Professor Simon Baron-Cohen: Right.

Sharon daVanport: I have an admission, Professor Baron-Cohen. I tried cheating on it, even. [Laughter] What I mean by “cheating” is…well, first, my score was 48. That’s my score.

Professor Simon Baron-Cohen: Right. 48 out of 50, so that’s a very high score.

Sharon daVanport: I know. Very autistic, right? [Laughter]

Professor Simon Baron-Cohen: It’s almost to the maximum of the test.

Sharon daVanport: Oh, wow. Now, I did not know that. So what I did is I’ve gone back, and a couple times I thought: “Wow. 48? No, there’s just no way! Not 48!” It’s like when I first received my diagnosis. I’m like: “I’m not autistic!”

Professor Simon Baron-Cohen: Right.

Sharon daVanport: I compared everything to my son who’s on the spectrum, thinking: “No, I’m nothing like him.” I compared that male-female thing. So what I did, Professor Baron-Cohen, and I’m saying this only because I had dozens and dozens of people over on Facebook do the same thing. To contact me and say: “Oh, I tried cheating, too.” I went in and what I did is I answered something that wasn’t necessarily not what I would do, but it was just a grade more towards what I felt a non-autistic would do.

Professor Simon Baron-Cohen: Okay, sure.

Sharon daVanport: Maybe if it was my second choice. If it was my second choice I would do.

Professor Simon Baron-Cohen: Yeah.

Sharon daVanport: Even my second choice, I scored a 33. [Laughter]

Professor Simon Baron-Cohen: Okay.

Sharon daVanport: So I’m thinking: “Okay.” [Laughter]

Professor Simon Baron-Cohen: Yeah.

Sharon daVanport: But then, it’s always a 48. That’s interesting. It’s inteesting.

Professor Simon Baron-Cohen: Okay. So what you’re saying is even if you tried to mask it, because this goes back to what you were saying about masking your autism, you still score very high. So 33, we would consider in the clinical range.

Sharon daVanport: Oh, okay.

Professor Simon Baron-Cohen: But this test is not diagnostic, and I should really underline that.

Sharon daVanport: Right. And it does say that on Facebook; it does.

Professor Simon Baron-Cohen: Yeah. And the second thing I should say is that we didn’t post it on Facebook, so somebody has designed this as an app and put it up there.

Sharon daVanport: Right; right. It says that; yes, it does.

Professor Simon Baron-Cohen: It’s difficult to control the Internet.

Sharon daVanport: Oh, I know.

Professor Simon Baron-Cohen: People do all kinds of things. But because of what you’re saying, that people might try and cheat on their scores, we don’t think that Facebook is really the right way to do research.

Sharon daVanport: Absolutely; absolutely. If someone wants to really partake in research, how do you recommend that they go about doing that? Those of us on the spectrum, we need a step-by-step guide.

Professor Simon Baron-Cohen: Yeah. I think what’s been very exciting about recent medical research is a lot more funding has been channeled towards autism research, which means many more universities right across the US and across the world, really, are starting to carry out their own research. So depending on where you live in the US, it may well be that there’s a university near you conducting autism research. Certainly in all the main centers, in Los Angeles, in New York, in UC Davis, plenty of different places have centers of excellence for autism research, and they’re always very positive about welcoming people on the autistic spectrum who want to take part in research. So just contact either your local university or, certainly, one of the universities in the main hubs, if you like.

The other way to find out about research is through the International Society for Autism Research. So the acronym there is “INSAR,” and they list what’s going on in autism research, and finally there’s a very good charity called the Simons Foundation, whose website I recommend. They also illustrate the research, the new findings as they’re published. They’ve got an excellent team of science journalists who are interviewing the scientists and translating the latest research into ordinary language.

Sharon daVanport: Wow. That’s really good to know. I also wanted to see if you could help us appreciate what we should and should not be looking for when we’re looking into some of this research. Some may just be something that may not be beneficial, so is there a guideline as to what we want to look for in a particular research? I’ve been contacted [by people who] said: “I partook in this one research and it turned out to be just so bogus.” How do you really know what’s legitimate and what’s not?

Professor Simon Baron-Cohen: Sure. What I would advise is in terms of interpreting any evidence out there, you should always check: Has it been published in a scientific journal that uses peer review? This is very important, because the Internet is such that people can post up all kinds of things in a blog or on a website which looks like it’s science, but unless it’s been published first in a scientific journal as a result or following the peer review process, then we can’t trust it. So peer review, as you may know, is where other scientists scrutinize the evidence before it gets published. They try to find the mistakes, or they try to find the conclusions that are invalid. That’s really the only mechanism that we have for checking that science is done well.

The second important thing to look for is that if somebody’s conducting some research, has it been through an ethics committee? In the UK we call it an ethics committee, but I think in the US you call it a human subjects committee. But it’s really a panel of people, partly scientists but partly people from the general community, just checking that the kind of research is ethical; that it’s not going to cause suffering and that people understand and are giving informed consent. They understand what they’re letting themselves in for.

Sharon daVanport: Right. Okay. That’s very good advice. I will make sure I pass it on to those who contact us at the AWN and are asking us that question. We do receive periodic questions along those lines, because many people want either their child or themselves to be involved in some kind of research.

Professor Simon Baron-Cohen: Sure.

Sharon daVanport: They really want to either contribute or really want to know what’s going on with their child or themselves.

Professor Simon Baron-Cohen: Yeah. And I think that’s fantastic that families and people themselves who have a diagnosis want to help research. So we should really encourage them to come forward. I should say that most research is trustworthy. It does go through this ethical review, and it does go through a peer review. But it’s just to watch out for some things that you might read in magazines or newspapers. Always check: Has it first appeared in a scientific journal, or has it been through an ethics committee?

Sharon daVanport: Okay. This is a perfect segue to lead into getting your expertise and speaking to our autism community on why research is really so important. Why it is so important to leading the way in just so many ways.

Professor Simon Baron-Cohen: Yeah. Well, we started off by talking about interventions like the DVD, and I think that when it comes to treatments or interventions, research is absolutely important. It’s vital in order to conduct a systematic evaluation. Is the intervention actually helping? And that’s a question that research can answer. The way it does that is by setting up trials like treatment trials where you’re comparing a group of people with autism who are given a particular intervention, and then a control group who are not.

There may be other comparisons as well, but very importantly, the design of the experiment, the design of the research, should be such that it’s possible for the study to show either that the treatment does benefit or that it has no benefit. Research is the only way that we can do that. The reason why it’s important is that almost every year a new treatment is announced for autism, and parents may be understandably chasing after a solution or chasing after help, and they need to know whether they’re either spending their own money wisely or whether they physician or the insurance company or the school are spending their money wisely. Again, research can help to give impartial evaluations of new treatments.

Sharon daVanport: Okay. And we do have some callers on our switchboard today, Professor Baron-Cohen. A lot of people, it looks like. We’re not going to be able to get to more than…I’m sorry for all the callers, but I just looked at the time.

Professor Simon Baron-Cohen: Sure.

Sharon daVanport: We’re not going to be able to get to everyone on the switchboard today. But I would like to at least try to take as many as we can. I’m going to go ahead and go to the switchboard now. It looks like we have someone in queue. Let’s see here. [Area code], welcome to AWN radio. You’re on the air.

Caller: I wonder if that’s me. Can you hear me?

Professor Simon Baron-Cohen: Yeah.

Sharon daVanport: Yes, it is.

Caller: Okay. I was surprised I’m number one. Thank you so much for this program, and for the research and for spreading the news about this research. My question has to do with comorbidity. I have a daughter with Asperger’s who’s a late teen in college and was diagnosed about seven or eight years ago with colitis and Crohn’s. I know a lot a lot of autistic spectrum, there’s connections with gut issues. But about two years ago, she was alos diagnosed with polycystic ovarian syndrome, PCOS, which I don’t know a whole lot about. Obviously it’s a female thing, not a male thing. But in a nutshell, I know that part of what it has is or what causes it is a higher level of testosterone than most women would have in their system.

Professor Simon Baron-Cohen: Yeah.

Caller: And correct me if this [phrase?] is wrong, because I could very well not have that science right. So when I began to read, Professor, about some of your other research and looking at the testosterone levels in ASD, I said [unknown]: “What’s some of the connections here between something like that?” Could you speak to that, please?

Professor Simon Baron-Cohen: Sure. In fact, our research was I think the first to show a link between women with autism spectrum conditions like Asperger’s and polycystic ovary syndrome, PCOS. PCOS, as you know, is a separate condition which is characterized by irregular menstrual cycles and a late onset of puberty or menstruation, but also excess hirsutism or bodily hair. As you rightly say, it’s caused by high levels of testosterone and by finding that in women with autism there are elevated rates of PCOS, that’s giving us a clue that females with autism may have high levels of testosterone, and we’re going on to check that in our current research.

Caller: Great. Thank you. I appreciate that.

Professor Simon Baron-Cohen: You’re very welcome. More importantly, because I’m just describing some basic research, is that your daughter and other people like her need to be getting the right support. It is important that we do research into causes like hormones and genetics, but equally it’s very important that the right services exist, and I hope that your daughter is getting the right support.

Caller: Yes. We’re fortunate to be in an urban area with very good medical care and she has me for a mom, so she gets a lot of resources. We’re very fortunate in that way. And it’s good to know that you read things things, and you think: “What are these connections? There’s something there,” and I don’t know where it will lead, but I appreciate that research that you’re doing.

Professor Simon Baron-Cohen: Okay. Thank you very much.

Caller: Thank you.

Sharon daVanport: Thank you for calling in.

[Caller hangs up]

Okay. Well, I looked at the time again, Professor Baron-Cohen, and we’re heading towards the end of the hour. What we like to do on AWN radio is we like to end our show by giving our guest the opportunity to speak to either something that we perhaps missed in our outline that we had prepared for, or something as well that you can include that you want to speak to our audience about that you would like to share.

Professor Simon Baron-Cohen: Sure. I’d like to tie it back to something we were talking about right at the beginning of this program today, which is the idea that girls who may have autism may remain undiagnosed much longer than boys, maybe because they’re masking it better. And that was really a comment you made. It was a very interesting speculation. But what it would imply is that maybe girls who have autism try to deal with it in a different way, by imitating what they think of as typical behavior in the peer group.

This is something that certainly we’ve heard anecdotally. I’m not aware of any research which has actually tried to test if it’s going on, if it’s true. But the idea might be that if a girl who’s struggling with developing relationships and communication might decide to use their good language and their good imitation skills to copy maybe a popular girl in the class. And that strategy might help them for many more years, compared to boys, who may have either less motivation or less skill in masking or imitation. So this is really just throwing out a new research idea, and obviously, it needs to be tested.

Sharon daVanport: Well, I thank you very much for sharing that with us, and I want to thank you again for being our guest. We certainly look forward to having you back again in the future, and thank you again for being a part of AWN’s advisory board, Dr. Baron-Cohen.

Professor Simon Baron-Cohen: Not at all. It’s been a pleasure talking to you today, and I want to wish the AWN every success.

Sharon daVanport: Well, thank you. Thank you very much, and you have a lovely day.

Professor Simon Baron-Cohen: Thank you. Bye-bye.

Sharon daVanport: Okay. Bye-bye.

[Professor Baron-Cohen hangs up].

Okay, everyone. That is going to do it for us today on AWN radio, the Autism Women’s Network on Blogtalk. I want to remind you that we’ll be back same time next week on Monday, and our guest will be Anna Moore. Anna is a mother who recently won a lawsuit against her son being restrained, and she is a die-hard advocate against restraint and seclusion. It’s a show you definitely do not want to miss. Again, thank you very much for all of our listeners joining us, and we’re sorry we couldn’t get to all the callers on the switchboard, and we thank you again. Have a lovely day. Bye-bye.

[End]

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